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目的探讨血清降钙素原(PCT)在监测脓毒血症患者病情及预后评估中的作用。方法选取2012年8月至2013年8月我院收治的80例脓毒血症患者,根据病情分为脓毒症组、重度脓毒症组和脓毒症休克组,同期收治的非脓毒血症患者48例为对照组。入院第1天、第3天、第5天检测其血清PCT水平,记录当天急性生理和慢性健康状况-Ⅱ(APACHE-Ⅱ)评分。结果血清PCT水平和APACHE-Ⅱ评分均为脓毒症休克组大于重度脓毒症组大于脓毒症组大于对照组,各组间差异有统计学意义(P<0.05),血清PCT水平与APACHE-Ⅱ评分呈正相关(r=0.58,P<0.05)。脓毒血症患者第1天血清PCT水平和APACHE-Ⅱ评分好转、无效和死亡患者间差异无统计学意义(P均>0.05),第3、5天血清PCT水平和APACHE-Ⅱ评分均为好转患者小于无效患者小于死亡患者,差异有统计学意义(P<0.05)。结论血清PCT水平与脓毒血症病情严重程度分级及病情预后转归有密切关系,随病情好转而降低,随病情恶化而升高,可作为脓毒血症患者病情监测和预后评估的观察指标。
Objective To investigate the role of serum procalcitonin (PCT) in monitoring the condition and prognosis of sepsis patients. Methods Eighty sepsis patients admitted from August 2012 to August 2013 in our hospital were divided into sepsis group, severe sepsis group and septic shock group according to their condition. Non-sepsis 48 patients with blood disease as control group. Serum PCT levels were measured on the first day, the third day and the fifth day after admission, and the acute physiology and chronic health-Ⅱ (APACHE-Ⅱ) score of the day were recorded. Results Serum PCT level and APACHE-Ⅱ score were higher in sepsis group than in sepsis group and sepsis group than in control group (P <0.05). There was significant difference between PCT levels and APACHE -Ⅱ score was positively correlated (r = 0.58, P <0.05). Serum PCT and APACHE-Ⅱ scores improved on the first day in patients with sepsis, but there was no significant difference between invalid and death patients (P> 0.05). The serum PCT levels and APACHE-Ⅱ scores on the first and third day were Improvement less than patients with less than invalid patients died, the difference was statistically significant (P <0.05). Conclusions Serum PCT levels are closely related to the grading of sepsis and the prognosis of sepsis, with the improvement of the disease condition and the increase of the serum PCT level, which can be used as an indicator to monitor the condition and prognosis of sepsis patients .